Claims Representative resume examples

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Skillful Claims Representative resume

Khadijah Stewart
Skills
  • Agile learner
  • Detail orientated
  • MS Windows proficient
  • Strong interpersonal skills
  • 45 WPM
  • Dependable/reliable
  • Shipping and receiving professional
  • ERP logistics database expert
  • Work History
    Information Referral Specialist, 04/2016 to Current
    Georgia Department of Driver Services Conyers, GA
    • Addressing constituents' concerns, transferring calls, and taking message when necessary.
    • Provide information about establishment, such as location of departments or offices, employees within the organization, or services provided.
    • Organizing calendars and scheduling appointments.
    • ​Resolve problems by clarifying issues; researching and exploring answers and alternative solutions; escalating unresolved problems and/or concerns.
    Warranty Administrator, 05/2016 to 03/2017
    American Customer Service Peachtree City GA
    • Kept records of customer interactions/transactions, recording details of inquiries, complaints and/or comments.
    • Reviewed claims adjustments with dealers/contractors for approval, i.e., examining defective parts.
    • Recommend improvements in product, packaging, shipping, service, or billing methods. 
    • Organized and worked with detailed office/warehouse records, using data key entry. 
    Claims Representative, 09/2014 to 03/2016
    Crawford & Company Atlanta, Georgia
    • Accurately handled and recorded incoming calls from insured, claimants, attorneys or agents in regards to first notice of claims.
    • Recorded 25 claims per hour.
    • Managed a wide variety of customer service and administrative tasks to resolve customer issues quickly and effectively.
    • Mastery of customer service management systems and database
    Administrative Assistant, 12/2013 to 09/2014
    Discovery Point Daycare Lawrenceville, GA
    • Managed office supplies, vendors, organization and upkeep.
    • Maintained a clean reception area, including lounge and associated areas.
    • Communicated regularly with parents about daily activities and behaviors.
    • Relief assistance for head and toddler teachers.
    • Receive payment and record receipts for services.
    • Monitored payments due from parents and promptly contacted clients with past due payments.
    Education
    Bachelor of Science: Nursing, Current
    Georgia State University - Atlanta, GA
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    Job-winning Claims Representative resume

    Melissa A Jadin
    Summary
    Highly effective Manager offering outstanding presentation, communication and team management skills. High-energy, results-oriented leader with an entrepreneurial attitude.
    Skills
    • Leadership/communication skills
    • Staff development/engagement
    • Customer service-oriented
    • Workflow planning
    • Organizational and time management skills
    •  Large loss negotiation skills
    •  Expense Control
    Accomplishments

    Developed and implemented a structured training program for a department of 50+ claims professionals to transition them to paperless file handling. The department was the first in the company to successfully make the transition. As a result, I became a consultant for other branches during their transitions.

    Created and led an interactive one-hour seminar as part of an advanced training program for Adjusters.  Program was well received and utilized for several years.

    Initiated an Adjuster on-boarding program in collaboration with Training & Development with a primary focus on creating immediate social connections within the company for newly hired Adjusters.This program was deployed two years ago and remains in place due to its success with employee engagement and retention.


    Experience
    Manager 10/2011 Amica Mutual Insurance Co Lincoln, RI
    • Manage a team of 80+ Claims professionals.
    • Maintain a department NPS score of 89% or higher
    • Achieved and maintains high department employee engagement scores (above 90%)
    • Accountable for maintaining company's stellar customer service reputation
    • Organize and analyze data to continually assess and improve department performance and align with corporate strategic and tactical goals and objectives
    • Evaluate, direct and/or negotiate serious claims for all lines of business (auto, home, marine, umbrella)
    • Virtually managed a subrogation team of 10 with members in FL, CT and RI.
    • Review proposed regulatory changes and provide input to senior management about their effect on claims operations.
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    Branch Claims Manager 10/2011 Albany, NY
    • Managed a team of 20+ claims professionals
    • Oversight of a PIP team virtual with NJ
    • Participated in regular PCI conference calls and functions
    • Teamed with Branch Sales Manager to initiate events focused on engaging employees office-wide
    • Evaluate, direct and/or negotiate serious claims for all lines of business (auto, home, marine, umbrella)
    • Reviewed proposed regulatory changes and provided input to senior management about their effect on claims operations.
    Assistant Branch Claims Manager 09/2010 Glastonbury, CT
    • Assisted with the management of 50+ claims professionals
    • Spearheaded the transition from paper to electronic claim files involving the development of a structured training program
    • High level of understanding and efficiency of the Guidewire Claim Center product
    • Instrumental in the planning and implementation of the department's move to a new location. Provided valuable input on layout and design and was responsible for the oversight of the physical move
    • Evaluate, direct and/or negotiate serious claims for all lines of business (auto, home, marine, umbrella).
    08/2010 Amica Mutual Insurance Co
    11/2005 Amica Mutual Insurance Co
    11/2005 Hauppauge, NY
    Senior Claims Supervisor 01/2000
    Claims Supervisor 01/1996
    Claims Representative 01/1991 to 01/1992
    Administrative Assistant 01/1988
    03/1987 Amica Mutual Insurance Co
    Customer Service Representative 01/1987
    Education and Training
    Associate of Applied Science: Business Administration 1998 Suffolk County Community College Selden, NY, USA Business Administration
    Business Certficate Program 1987 Katharine Gibbs School Huntington, NY, USA
    Business Administration Nichols College Dudley, MA, USA Business Administration
    Certifications
    Continuing Education
    • Adjusters Licenses in RI and CT Community Service Volunteer, RI Chapter of CPCU, 2012-Present President 2015 President-Elect, 2014 Vice President, 2013 Programs Chair, 2012 Sugar Angel, Icing Smiles, 2014-Present First Lights Instructor, St. Joseph's Parish, 2014-Present
    Skills
    communication skills, Customer service, senior management, layout and design, Leadership, office, negotiation, Organizational, PCI, Sales Manager, Staff development, strategic, structured, time management, Workflow
    Additional Information
    • Licensing Adjusters Licenses in RI and CT Community Service Volunteer, RI Chapter of CPCU, 2012-Present President 2015 President-Elect, 2014 Vice President, 2013 Programs Chair, 2012 Sugar Angel, Icing Smiles, 2014-Present First Lights Instructor, St. Joseph's Parish, 2014-Present
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    Top Claims Representative skills

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    Experienced Claims Representative resume

    Sherry Whitney
    Summary
     
     
    Acquire a challenging career at which I can be an intricate part.
    Skills


    Strong interpersonal and communication skills

    Workers' compensation claims

    Self-directed

    Analytical

    Team player

    Decisive

    Critical thinker



    Insuance Claims Clerk
    July 2007
    to
    March 2017
    Ticket Seasons Manchester, NH Bartender

    Maintained full knowledge of bar and menu items and made recommendations.
     
    Delivered quality food and beverage service to guests in a responsible manner.
     
    Delivered food and beverage orders within established timeframes
     
    Maintained full knowledge of all menu items, contents and preparation methods.
    Served as backup for bartenders.
     
    Opened and closed bar tabs and transferred tabs to dining area.
     
    Processed cash, credit card and voucher payments.
     
    Maintained bar stocks, replenishing daily as necessary.
     
    Served each guest with a sincere, positive, pleasant and enthusiastic attitude.
     
    Made engaging connections with guests to create loyalty.
    Stocked beer and wine coolers.
    January 2005
    to
    January 2007
    Ramada/Amoskeag Inn Manchester, NH Bar Manager/House Keeping Supervisor
    Dealt with all facets of the business including management of housekeeping, maintenance and front desk procedures.
     
    Kept daily records of sales and  operating cost, including purchasing and orders.
     
    Self Managed and promoted sales for integrated bar establiment "Mixers Martini Bar".
     
    Integrated new ideas to broaden our customer base.
     
    Promoted activities and entertainment.
     
    Dealt with all facets of the business including suppliers, the New Hampshire Liquor Commision, the Manchester Health Department, and all vendors
     
     Escellent customer service and genuine concern for customer satisfaction.
    January 2004
    to
    January 2005
    Derryfield Country Club Mancehster, NH Bartender

    First rate customer service.

     
    Established vast customer following.
     
    Precise handling of money factor before, during and closings of shifts
     
    Performed all duties associated with the business, including bar and waitress service.
    January 2001
    to
    January 2003
    Cahoots Sports Bar & Grille Manchester, NH Bartender
    Assistant Manager of bar in a high activity environment
     
    Demonstrated excellent customer service and genuine concern for customer satisfaction 
     
    Performed all duties associated with the business, including bar and waitress service, hostess service and supervision
    January 1995
    to
    January 2001
    Bogies Golf & Blilliards Manchester, NH Assistante Manager/Bartender
    Responsible for opening and closing or establishment
     
    Preformed daily inventory
     
    Served as a bartender and waitress including preparation of food and cocktails.
    January 1994
    to
    January 1995
    Willis Corroon Rochester, NH Senior Claims Representative
    Sales and negotiation of new and pre-existing claims.
     
    Investigated all cases from inception to closure
     
    Monitored independent rehabilitation and special investigation providers
     
    Integrated new ideas to broaden customer bases
     
    Worked closely with defense counsel on litigated matters.
    July 1988
    to
    October 1992
    Crawford & Company Bedford, NH Claims Adjuster II

     Dedicated workers' compensation claims adjuster working with self-insured and major insurance carriers.

    Coordinated lost time cases from inception to closure.
    Negotiated discounts with independent rehabilitation providers.
     
    worked closely with defense counsel.
     
    Managed early return to work programs.
    July 1983
    to
    July 1988
    NH Inusrence Group Manchester, NH Claims Clerk
    Created databases and spreadsheets to improve inventory management and reporting accuracy.
    Standardized department filing system to increase efficiency.
     
    Maintained detailed administrative and procedural processes to improve accuracy and efficiency.
     
    Verified and logged in deadlines for responding to daily inquiries.
    New Hampsire Hospital Association Concord, NH Claims Representative
    Obtained relevant evidence and information regarding suspicious claims. Investigated lost time cases from inception to closure for a $6 million dollar, self-insured company.
    Conducted periodic case reviews with insured clients to manage claims and maintain good insured relations.
     
    Monitored independent rehabilitation and special investigation providers.
     
    Worked closely with defense counsel in litigated cases.
     
    Assisted insured by implementing and enhancing alternative duty programs
     
    Negotiated resolution of claims with claimants" attorneys to minimize costs to insured.
    Education and Training
    1983
    Central Hight School Manchester, NH, USA General
    1988
    Crawford & Co Atlanta, GA, USA Insurance
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